What Did We Learn from Our Cochlear Implant Revisions?

Document Type : Original

Authors

1 Department of Otorhinolaryngology/Head and Neck Surgery, Kozyatagı Acıbadem Hospital, Istanbul, Turkey.

2 Department of Otorhinolaryngology/Head and Neck Surgery, University of Health Sciences Istanbul Education and Research Hospital, Istanbul, Turkey.

3 Department of Otorhinolaryngology/Head and Neck Surgery, Dr.Şinasi Can (Kadıkoy) Acıbadem Hospital, Istanbul, Turkey.

Abstract

Introduction:
We aimed to report our clinic’s 11-year experience with cochlear implant (CI) revision surgeries.
Materials and Methods:
This was a retrospective observational study. Patients who underwent CI and revision surgery at the same tertiary institution were enrolled in the study. Patients whose primary surgery was performed at another institution were excluded from the study. The patients’ clinical charts, surgical records, and audiological and oral language outcomes were retrospectively examined.
Results:
Thirty-three (29 children, 4 adults) of 720 patients (871 CI) at our clinic required revision surgery, representing a revision surgery rate of 4.58%. The most common reason for revision was device failure (10 patients), followed by skin and electrode problems, with electrode tip fold-over in 6 patients, a broken electrode cable in 1 patient, skin flap complications in 6 patients, displacement of the magnet in 1 patient, cholesteatoma in 1 patient, electrode migration in 6 patients, misplacement of the electrode array into the internal acoustic canal in 1 patient, and explantation of the electrode cable in the external auditory canal in 1 patient. We had only one major complication after revision surgery.
Conclusion:
We recommend performing routine postoperative imaging, even if intraoperative telemetries are normal, to diagnose electrode misplacement or electrode tip fold-over. Additionally, we recommend long-term regular follow-up of children, in particular, because our study showed that the number of revision surgeries was higher in children who received implants at an early age.

Keywords

Main Subjects

References

  1. Hochmair-Desoyer I, Burian K. Reimplantation of a molded scala tympani electrode: Impact on psychophysical and speech discrimination abilities. Ann. Otol. Rhinol. Laryngol. 1985; 94:65–70
  2. Rivas A, Marlowe AL, Chinnici JE, Niparko JK, Francis HW. Revision cochlear implantation surgery in adults: Indications and results. Otol. Neurotol. 2008; 29:639–48.
  3. Balkany TJ, Hodges AV, Gómez-Marín O, Bird PA, Dolan-Ash S, Butts S et al. Cochlear reimplantation. Laryngoscope 1999; 109:351–5.
  4. Henson AM, Slattery WH 3rd, Luxford WM, Mills DM. Cochlear implant performance after reimplantation: A multicenter study. Am. J. Otol. 1999; 20:56–64.
  5. Côté M, Ferron P, Bergeron F, Bussiere R. Cochlear reimplantation: Causes of failure, outcomes and audiologic performance. Laryngoscope 2007; 117:1225–35.
  6. Amaral MSAD, Reis ACMB, Massuda ET, Hyppolito MA. Cochlear implant revision surgeries in children. Braz. J. Otorhinolaryngol. 2019; 85: 290–6.
  7. Brown KD, Connell SS, Balkany TJ, Eshraghi AE, Telischi FF, Angeli SA. Incidence and indications for revision cochlear implant surgery in adults and children. Laryngoscope 2009; 119:152–7.
  8. Jiang Y, Gu P, Li B, Gao X, Sun B, Song Y et al. Analysis and management of complications in a cohort of 1,065 minimally invasive cochlear implantations. Otol. Neurotol. 2017; 38:347–51.
  9. Kim SY, Kim MB, Chung WH, Cho YS, Hong SH, Moon IJ. Evaluating reasons for revision surgery and device failure rates in patients who underwent cochlear implantation surgery. JAMA Ot Head Neck Surg. 2020; 146:414–20.
  10. Rayamajhi P, Kurkure R, Castellino A, Kumar S, Ha M, Nandhan R et al. A clinical profile of revision cochlear implant surgery: MERF experience. Cochlear Implants Int. 2021; 22:61–7.
  11. Cullen RD, Fayad JN, Luxford WM, Buchman CA. Revision cochlear implant surgery in children. Otol. Neurotol. 2008; 29:214–20.
  12. Gosepath J, Lippert K, Keilmann A, Mann WJ. Analysis of fifty-six cochlear implant device failures. ORL J. Otorhinolaryngol. Relat. Spec.2009;71: 142–7.
  13. Davids T, Ramsden JD, Gordon KA, James AL, Papsin BC. Soft tissue complications after small incision pediatric cochlear implantation Laryngoscope 2009; 119:980–3.
  14. Hopfenspirger MT, Levine SC, Rimell FL. Infectious complications in pediatric cochlear implants. Laryngoscope 2007; 117:1825–29.
  15. Low WK, Rangabashyam M, Wang F. Management of major post-cochlear implant wound infections Eur. Arch. Otorhinolaryngol. 2014; 271: 2409–13.
  16. Garcia-Valdecasas J, Jimenez-Moleon JJ, Sainz M, Fornieles C, Ballesteros JM. Prophylactic effect of clarithromycin in skin flap complications in cochlear implants surgery. Laryngoscope 2009; 119:2032–6.
  17. Ikeya J, Kawano A, Nishiyama N, Kawaguchi S, Hagiwara A, Suzuki M. Long-term complications after cochlear implantation. Auris. Nasus. Larynx. 2013; 40:525–9.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Zuniga MG, Rivas A, Hedley-Williams A, Gifford RH, Dwyer R, Dawant BM et al. Tip fold-over in cochlear implantation: Case series. Otol. Neurotol. 2017; 38:199–206.
  2. Grolman W, Maat A, Verdam F, Simis Y, Carelsen B, Freling N et al. Spread of excitation measurements for the detection of electrode array foldovers: A prospective study comparing 3-dimensional rotational x-ray and intraoperative spread of excitation measurements. Otol. Neurotol. 2009; 30:27–33.
  3. Lassig AA, Zwolan TA, Telian SA. Cochlear implant failures and r Otol. Neurotol. 2005; 26:624–34.
  4. Nichani JR, BroomWeld SJ, Saeed SR. Displacement of the magnet of a cochlear implant receiver stimulator package following minor head trauma. Cochlear Implants Int. 2004; 5:105–111
  5. Yun JM, Colburn MW, Antonelli PJ. Cochlear implant magnet displacement with minor head trauma. Otolaryngol. Head Neck Surg. 2005; 133: 275–7.
  6. Halawani R, Aldhafeeri A, Alajlan S, Alzhrani F. Complications of post-cochlear implantation in 1027 adults and children. Ann. Saudi. Med. 2019; 39: 77–81
  7. Kaila R, Evans RA. Cochlear implant infection due to cholesteatoma. Cochlear Implants Int. 2005; 6:141–6.
  8. Bort A, Portmann D, Guindi S. Cholesteatoma presenting as a late complication of cochlear implant surgery: Case report and literature review. Laryngol. Otol. Rhinol. (Bord) 2015; 136:67–71.
Iranian Journal of Otorhinolaryngology
Volume 37, Issue 3
May and June 2025
Pages 143-150

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